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PubMed1982

Factor analysis of the Revised Wechsler Memory Scale tests in a neuropsychological battery.

The Revised Wechsler Memory Scale (4 scales) along with 13 subtests from the WAIS and Halstead-Reitan battery were subjected to a principal components factor analysis. 9 tests of memory loaded on 5 of the 6 factors indicating that 5 types of memory were isolated. These were immediate verbal memory, recent verbal memory, recent figural memory, figural learning, verbal learning storage. Loading of memory and nonmemory tests on the same factors indicates a closer relationship between some memory and nonmemory processes than between kinds of memory.

Brain Damage, Chronic↗
PubMedDate not supplied

Impact of risperidone versus haloperidol on activities of daily living in the treatment of refractory schizophrenia.

Risperidone has been shown to improve verbal working memory, executive functioning, attention, reaction time, and verbal learning, which, in turn, have been associated with improved functional outcomes. We tested whether risperidone was associated with greater improvements than haloperidol in activities of daily living (ADLs) among persons having treatment-refractory schizophrenia. In a double-blind, controlled trial of fixed and flexible doses of haloperidol and risperidone, changes in ADLs were operationally monitored on a behavior therapy unit of a state hospital. While no differential effects were noted between risperidone and haloperidol in ADLS, these self-care skills significantly improved as subjects spent longer times on the behavior therapy unit. Working memory and verbal learning did correlate with improvements in ADLs, independent of drug condition. The contingencies of reinforcement and specific training programs on the behavior therapy unit may have been prepotent for the learning of ADLs, obscuring any differential impact of risperidone. Moreover, ADLs may be governed more by "procedural" learning than by working memory or verbal learning, with the former not differentially influenced by typical verus atypical antipsychotics.

Activities of Daily Living↗
PubMed2005

Defining meaningful postoperative change in epilepsy surgery patients: measuring the unmeasurable?

Two hundred and ninety epilepsy surgery patients completed the Hospital Anxiety and Depression Scale and were assessed on a list learning task preoperatively and 1 year postoperatively. Deterioration and improvement in verbal memory were determined using reliable change indices (RCIs) at 80 and 90% confidence limits. Almost one third of patients (27%) experienced a deterioration in verbal learning. The number of left temporal lobectomy patients who had deteriorated outnumbered the right temporal lobectomy patients by 2:1. Significant improvements in verbal learning were seen in 21% of the right temporal lobectomy group and 10% of the left temporal lobectomy group. Patients who were seizure-free postoperatively were not more likely to experience a postoperative deterioration or improvement in memory than those who continued to experience seizures. No significant relationships were found between subjective ratings of postoperative memory function and objective indices of change. Reliable, objective indices of postoperative deterioration in memory function may bear little relation to the patient's subjective experience. This should be considered when statistical predictions are used as the basis of preoperative counseling.

Adult↗
PubMed2002

Improvement in neuropsychological performance following surgical treatment for obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change -39, SD 57.3, p < 0.001), recall (mean change -24.3, SD 39.3, p < 0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change -9.1, SD 15.7, p < 0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p < 0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p < 0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.

Humans↗
PubMed1988

Transient global amnesia and migraine.

Formal neuropsychological evaluation in patient with transient global amnesia (TGA) associated with migraine was performed 6 days and 17 months after the episode. Verbal learning difficulties and verbal IQ deficit were observed in line with the neuropsychological profile seen in the follow-up of TGA. A common origin for the TGA-Migraine episode and isolated TGA is discussed.

Amnesia↗
PubMedDate not supplied

[Assessment of short-term neuropsychologic changes after normothermic versus hypothermic coronary artery bypass grafting].

BACKGROUND: Coronary artery bypass grafting (CABG) is one of the main methods of treatment of coronary artery disease. Neuropsychological testing is a sensitive method for quantitative assessment of cognitive dysfunctioning following cardiopulmonary bypass. The aim of the present clinical study was to evaluate the neuropsychologic changes in CABG patients, operated with normothermic or hypothermic cardiopulmonary bypass (CPB). METHODS: Neuropsychological changes were assessed in 33 first-time CABG patients before and 3-10 days after surgery. Patients underwent CABG with hypothermic (Gr. H, n = 17) or normothermic (Gr. N, n = 16) CPB with standard anesthesia. Neuropsychological performance was assessed using a well-established battery of 10 tests. A neuropsychological test battery includes: Digit Span-subtest of WAIS-R (PL), the Trail Making Test, Raven Test, Benton, Bourdon, Verbal Fluency (F,A,S), Turm von Hanoi, Rey Auditory Verbal Learning Test, Supermarket, WAIS-R (PL) Digit Symbol-subtest of WAIS-R (PL). All patients completed the test for perception, attention, immediate and delayed verbal and visual memory, visual and verbal learning, problem-solving strategies, abstraction, recognition, word fluency, visual- motor coordination and psychomotor speed. For comparison, the incidence of decline using the 1.5 standard deviation (at least in 2 tests) also was calculated. RESULTS: Comparing the reliable change and SD methods, statistically significant differences in the incidence of decline were observed in 6 of the 10 neuropsychological measures. Patients' scores showed a significant deterioration in concentration of attention, immediate verbal memory, psychomotor speed, visuoconstructive tasks and verbal learning. Neuropsychological deficits were found in 66.7% of patients after surgery. Post-operative deficits were not associated with the method used (normothermia or hypothermia).

Adult↗
PubMed2004

Brain metabolites and cognitive function among older depressed and healthy individuals using 2D MR spectroscopy.

Brain metabolites of choline (Ch) and myo-Inisotol (mI) have been reported as elevated among geriatric depressed patients. Two-dimensional (2D) magnetic resonance spectroscopy (MRS) provides estimates of Ch, mI, and creatine (Cr) similar to one-dimensional MRS, and it also estimates the resonances of the Ch-containing compounds of phosphoethanolamine (Pe) and phosphocholine (PCh). In this cross-sectional geriatric study, 14 depressed patients and 14 healthy volunteers who were comparable in age, gender, education, comorbid medical burden, and Mini-Mental State Examination (MMSE) scores completed 2D MRS and a neurocognitive battery. A voxel in the left dorsolateral cortex, which was comprised of approximately 60% white matter, was used to estimate the CR ratios of Ch, PCh, Pe, and mI. Composite scores for cognitive function were developed for verbal learning, recall, recognition, executive function, hypothesis generation, and processing speed. Among nondepressed subjects, cognition was positively correlated with Ch/Cr and mI/Cr and negatively correlated with PCh/Cr in four domains of verbal learning, recognition, recall, and hypothesis generation. In contrast, depressed patients did not have consistent relationships between Ch/Cr, mI/Cr, and PCh/Cr and cognition. There was a significant difference in the overall pattern of associations between the four metabolites and verbal learning and processing speed in depressed patients compared to healthy controls. The attenuated relationship between metabolites and specific cognitive domains in patients with late-life MDD suggests that the level of cognitive performance observed during depressive episodes may be associated with changes in biochemistry within the frontostriatal neuronal circuitry.

Age Factors↗
PubMed2001

Mapping callosal morphology and cognitive correlates: effects of heavy prenatal alcohol exposure.

BACKGROUND: Abnormalities of the corpus callosum (CC) have been documented in fetal alcohol syndrome (FAS), ranging from subtle decrements in its size to partial and even complete agenesis. Prenatal exposure to alcohol is also known to result in neurocognitive deficits. OBJECTIVE: To 1) investigate abnormalities in size, shape, and location of the CC within the brain in individuals with FAS and in those exposed to high amounts of alcohol prenatally but without FAS (PEA group); and 2) determine if there is a relationship between callosal dysmorphology and cognitive test performance. METHODS: MRI and novel surface-based image analytic methods were used. Twenty alcohol-exposed subjects (8 to 22 years) along with 21 normal controls (8 to 25 years) were studied with high-resolution MRI and measures of verbal learning and visuospatial abilities. RESULTS: In addition to callosal area reductions, most severe in the splenium, the CC is significantly displaced in patients exposed to alcohol prenatally. In the alcohol-exposed group, this structure lies more anterior and inferior in posterior regions with relatively normal localization of anterior regions. These findings are significant in the FAS group, and a similar but less severe pattern is observed in the PEA patients. The authors show that the amount of CC displacement is correlated with impairment in verbal learning ability and that CC displacement is a better predictor of verbal learning than regional CC area. The brain-behavior relationship is only significant within the alcohol-exposed group, and the effect is not solely mediated by overall impaired verbal intellectual functioning. CONCLUSIONS: These results further emphasize the vulnerability of midline brain structures to prenatal alcohol exposure.

Adolescent↗
PubMed2003

Neuropsychological sequelae of exposure to welding fumes in a group of occupationally exposed men.

This study compares the neuropsychological function, emotional status, visual function, and illness prevalence of 76 former and current chemical industry welders primarily involved in steel welding, and exposed to welding fumes for an average of 24.9 years with that of 42 unexposed, non-welder controls. Health and occupational history questionnaires were administered, as were the neuropsychological tests included in the World Health Organization Neurobehavioral Core Test Battery, Luria Motor Test, and selected tests from the WAIS-III, and WMS-III. Emotional status tests included the BSI, POMS, BAI, and BDI, and vision tests included the Snellen near visual acuity, Lanthony d-15 color vision, Vistech Contrast Sensitivity, and Schirmer strips. While welders and controls performed similarly on tests of verbal skills, verbal retention, and auditory span, welders performed worse than controls on tests of verbal learning, working memory, cognitive flexibility, visuomotor processing speed, and motor efficiency. Welders had poorer color vision and emotional status, and increased prevalence of illnesses and psychiatric symptoms. The increased symptoms in welders were related to decreased scores on tasks measuring verbal learning, visuomotor abilities, visuospatial abilities, and information processing, and motor efficiency. Within the group of welders, the number of hours welding was negatively related to scores on verbal learning, auditory span, working memory, cognitive flexibility, and motor efficiency.

Adult↗
PubMedDate not supplied

[A neuropsychological study of triplets with a history of prematurity].

INTRODUCTION AND AIMS: Prematurity has often been associated with a general intellectual deficit and with different structural brain disorders which can be revealed by volumetric measurements performed by magnetic resonance imaging (MRI). In turn, perinatal asphyxia, even when it is not accompanied by neurological disorders, is related to a deficit in specific neuropsychological functions. CASE REPORT: This study describes the case of three 13 year old female triplets, with a history of extreme prematurity and perinatal asphyxia, the long term effects of which are evaluated in terms of cognitive performance. We studied their performance in the neuropsychological functions of intelligence, memory, and visual perceptual, visual constructive, visual spatial and frontal functions. In two of the subjects, structural MRI and volumetric analysis of the hippocampuses were performed. In all the subjects, intelligence was found to be above average, the most notable result being the superior score in case 1. Verbal learning and the long term retention of verbal material were altered in case 3, where there was also a smaller hippocampal volume. CONCLUSIONS: In the context of a multiple birth, we have seen that extreme prematurity, accompanied by non severe perinatal asphyxia without hypoxic ischemic encephalopathy, can exert very diverse effects on neurocognitive development. It can be normal, and even superior, or show a deficit in some skill. In our case, the functions that were most liable to suffer these antecedents are long term memory and verbal learning. This disorder is accompanied by bilateral involvement of the hippocampus, which can be observed using MRI.

Adolescent↗
PubMed2006

Verbal memory decline after temporal epilepsy surgery?: A 6-year multiple assessments follow-up study.

OBJECTIVE: To assess the long-term effects of temporal lobe epilepsy surgery on verbal memory. METHODS: We assessed verbal memory performance as measured by a verbal learning test ("15 Words Test," a Dutch adaptation of Rey's Auditory Verbal Learning Test) before surgery and at three specific times after surgery: 6 months, 2 years, and 6 years in 85 patients (34 left temporal lobe [LTL] vs. 51 right temporal lobe [RTL]). An amygdalo-hippocampectomy and a neocortical temporal resection between 2.5 and 8 cm were carried out in all patients. RESULTS: LTL patients showed an ongoing memory decline for consolidation and acquisition of verbal material (both 2/3 SDs) for up to 2 years after surgery. RTL patients at first showed a gain in both memory acquisition and consolidation, which vanished in the long term. Breaking the group up into a mesiotemporal (MTS) group and a non-MTS group showed clear differences. The group with pure MTS showed an overall lower verbal memory performance than the group without pure MTS, in the LTL group more pronounced than in the RTL group. After surgery, both pathology groups showed an ongoing decline for up to 2 years, but the degree of decline was greater for the LTL patients with MTS compared with the non-MTS group. Becoming and remaining seizure-free after surgery does not result in a better performance in the long term. Predictors of postoperative verbal memory performance at 6 years after surgery were side of surgery, preoperative memory score, and age. CONCLUSIONS: The results provide evidence for a dynamic decline of verbal memory functions up to 2 years after left temporal lobectomy, which then levels off.

Adult↗
PubMed1998

Impact of pediatric traumatic brain injury on components of verbal memory.

This 3-month longitudinal study examined spared and impaired components of verbal learning and memory after pediatric traumatic brain injury (TBI), using the California Verbal Learning Test for Children. School-aged participants with severe or mild-to-moderate TBI were compared to traumatically injured control subjects without head trauma. Participants were initially evaluated approximately 1 month post injury, and again 3 months later. At Times 1 and 2, participants with severe TBI displayed deficits in immediate recall, delayed recall, and recognition accuracy, consistent with a mild encoding deficit. In both evaluations, participants with mild-to-moderate TBI performed similarly to controls. On average, mild verbal encoding deficits appear to be associated with severe, but not mild-to-moderate, pediatric TBI in the first several months post injury.

Brain Damage, Chronic↗
PubMed2006

Homocysteine, folate, and vitamin B-12 and cognitive performance in older Chinese adults: findings from the Singapore Longitudinal Ageing Study.

BACKGROUND: The relations of elevated homocysteine, low folate, and vitamin B-12 with cognitive performance in nondemented elderly are not well established. Limited research data suggest differential effects of homocysteine and folate on specific cognitive domains. OBJECTIVE: The aim was to examine the independent associations of homocysteine, folate, and vitamin B-12 with cognitive performance in high-functioning elderly Chinese. DESIGN: Homocysteine, folate, and vitamin B-12 concentrations were measured in fasting blood samples of 451 Chinese aged >or=55 y with Mini-Mental State Examination scores >or=24 and who were considered fully independent based on Activities of Daily Living score. Cognitive functions were assessed by a neuropsychological test battery. Independent associations (standardized beta) were determined in multiple linear regression models that simultaneously controlled for potential confounders. RESULTS: Log-transformed homocysteine was inversely associated with performance on Block Design (beta = -0.319, P = 0.006) and the written Symbol Digit Modality Test (beta = -0.129, P = 0.031). Log-transformed folate was significantly associated with Rey Auditory Verbal Learning Test delayed recall (beta = 0.139, P = 0.010), verbal learning (beta = 0.112, P = 0.038), percentage of forgetting (beta = -0.139, P = 0.013), and the Categorical Verbal Fluency test (beta = 0.104, P = 0.042). Vitamin B-12 was not significantly associated with any cognitive test score. CONCLUSIONS: In this high-functioning elderly Chinese population, elevated homocysteine is associated with deficits in constructional ability and processing speed and folate is associated with measures of episodic memory and language. Our results provide support for differential effects of homocysteine and folate on specific cognitive functions.

Aged↗
PubMedDate not supplied

[Executive and amnestic functions of a group of first-degree relatives of schizophrenic patients].

Several lines of evidence seem to indicate that some neurocognitive measures could be phenotypic markers of predisposition to schizophrenia. The aim of this study was to investigate 21 patients with schizophrenia, 51 of their first-degree relatives and 46 nonpsychiatric controls, with a series of tests known to be sensitive to prefrontal cortical damage--the Trail Making Test, part B (TMT B), the Wisconsin Card Sorting Test (WCST) and a verbal fluency test (VFT)- and/or sensitive to temporo-hippocampic dysfunctions: verbal and visual memory and verbal learning tests from the Wechsler Memory Scale-Revised (Wechsler, 1987). Since parents and siblings share on average 50% of their genes with the schizophrenic proband, firstly we predicted that the first-degree relatives' performance would be at an intermediate level between patients and control subjects and secondly, we expected that a higher proportion of relatives than of control subjects would be impaired. The patients demonstrated deviant patterns of neuropsychological performance on the three tests sensitive to frontal dysfunctions and on most of the memory and learning tests. In the relative group, performance on the TMT B, VFT, immediate verbal recall and verbal learning was at an intermediate level between both other groups and significantly impaired compared to control subjects. However, the relative group did not differ from the control group on the WCST, immediate visual recall, and delayed verbal and visual recalls. Furthermore, compared to the control group, the percentages of patients and relatives who scored one standard deviation below the mean control group were significantly higher for the VFT and immediate verbal recall scores. Among all the tests studied, the verbal fluency and the immediate verbal recall appeared to be valuable phenotypic markers of schizophrenia since: (i) their mean scores were poorer in the patient and in the relative groups, (ii) the percentages of patients and relatives with poor performance were higher than the percentage of controls, (iii) these deficits were not due to poorer general intellectual abilities in the relative group, (iv) these deficits did not correlate with anxiety or depression scores.

Adult↗
PubMed2000

[Cognitive impairment in the early postoperative period after remifentanil-propofol and sevoflurane-fentanyl anesthesia].

OBJECTIVE: In ambulatory anaesthesia the time required to recover from cognitive impairment should be as short as possible. The aim of this study was to compare the early cognitive recovery after remifentanil/propofol (R/P) and sevoflurane/fentanyl (S/F) anaesthesia. METHODS: Sixty patients scheduled for elective gynaecological laparoscopy and 24 female volunteers tested for the assessment of learning effects were investigated. After praemedication with midazolam anaesthesia was induced with propofol, atracurium and either 1 microgram/kg fentanyl or 1 microgram/kg remifentanil. For maintenance 0.25 microgram/kg/min remifentanil and 0.6 mg/kg/min propofol (R/P) or 1.7 vol% sevoflurane (S/F) were given. Both groups were ventilated with 30% oxygen in air and received metamizol for postoperative analgesia. Verbal Learning Test, Stroop Colour and Word Interference Test, Digit Symbol Substitution Test and Four Boxes Test were performed the day before surgery and 30 min, 1 h, 2 h and 4 h after termination of anaesthesia. RESULTS: For remifentanil/propofol cognitive function was still impaired 2 h (Verbal Learning) and 4 h (Stroop, Digit Symbol Substitution and Four Boxes Test) after termination of anaesthesia. After sevoflurane/fentanyl anaesthesia cognitive impairment lasted the same duration in Four Boxes Test, but shorter in Stroop and Digit Symbol Substitution and could not be found in Verbal Learning Test. CONCLUSION: The duration of cognitive impairment in the early postoperative period differed by the test procedures and the anaesthetic procedures used in this investigation. Recovery appeared to be faster after sevoflurane/fentanyl than after remifentanil/propofol at least in aspects of cognitive function.

Adult↗
PubMed1996

The mechanisms of spontaneous and provoked confabulations.

Confabulation is a mysterious adjunct of amnesia. It remains unexplained why some patients invent untrue stories in response to questions (provoked confabulations) or even spontaneously with no apparent motivation (spontaneous confabulations). Hypothesized mechanisms range from a desire to fill gaps in memory to a loss of the temporal context in memory. We examined the mechanisms of confabulations in 16 amnesic patients. Patients were classified as spontaneous confabulators if they ever acted according to their confabulations. Provoked confabulations were measured as the number of intrusions in a verbal learning test. We found a double dissociation between the two types of confabulations, indicating that they represent different disorders rather than different degrees of the same disorder. Confabulating patients did not show an increased tendency to fill gaps in memory as measured by the number of fake questions concerning nonexistent items that they answered. Neither type of confabulation correlated with a failure to store new information as gauged with recognition tasks; pure information storage was even found to be normal in some patients. However, we found a positive correlation between several measures of verbal learning and verbal fluency with provoked, but not spontaneous, confabulations. In contrast, spontaneous, but not provoked, confabulations were associated with an inability to recognize the temporal order of stored information as measured by the comparison of two runs of a continuous recognition task. We suggest that provoked confabulations depend on an amnesic subject's search in his deficient memory and are the trade-off for increased item recollection. Spontaneous confabulations appear to be based on a failure to recognize the temporal order of stored information, resulting in erroneous recollection of elements of memory that do not belong together.

Adult↗